HISTORY OF OHAfrica

In March 2010, OHAfrica, a small Canadian international health organization, announced the successful conclusion of its HIV/AIDS program in Lesotho, a small country in southern Africa with one of the highest HIV infection rates in the world.  For more than five years, OHAfrica worked in partnership with the Lesotho Ministry of Health and Social Welfare (MOHSW) to help build a locally sustainable HIV/AIDS treatment program and to support the training of local health care professionals in the delivery of integrated HIV/AIDS care within the public health system.

Launched on World AIDS Day, December 1st, 2004, OHAfrica began as a joint initiative of the Ontario Hospital Association and The Change Foundation in response to an appeal by Stephen Lewis, the former UN Special Envoy for HIV/AIDS in Africa to Ontario hospital executives to engage in the global fight against HIV/AIDS. During its five years of operation, OHAfrica accomplished a great deal, including the introduction of antiretroviral (ARV) drug treatment programs for people living with HIV/AIDS in Lesotho, and supporting the development of one of the largest HIV/AIDS treatment centres in the southern African region.

In December 2004, the first team of Canadian health care professionals and HIV experts arrived at Tšepong Clinic to work side by side with their Basotho colleagues to establish what quickly began the largest HIV treatment centre in Lesotho.  Tšepong Clinic was one of the first public HIV/AIDS treatment centres opened in Lesotho when ARV treatment became available to developing nations at an affordable cost.  Tšepong means “Place of Hope” in the Sesotho language, and Tšepong Clinic has truly offered hope to the thousands of individuals and families who have benefited from its services.

When OHAfrica arrived in Lesotho in December 2004, there were only 116 HIV positive patients registered at Tšepong Clinic and 9 patients enrolled on the newly available, life-extending antiretroviral drug therapy (ARVs).  By March 2010, over 11,492 HIV positive individuals had ever been registered as patients at the clinic and 5,156 individuals had been enrolled on lifesaving antiretroviral drugs, including 423 children under the age of 14. 

In addition to providing direct care services, OHAfrica focused on capacity building and infrastructure strengthening to develop Tšepong Clinic into a vital and sustainable part of the Lesotho’s national HIV/AIDS health infrastructure. By the end of 2009, the staff of Tšepong Clinic was confident, HIV-competent, and ready to take on the running of the clinic without a need for continued external support.  During his time working with the team in December 2009, Dr. Philip Berger, the founding OHAfrica team leader and head physician in 2004/2005, stated: “the capacity has been built” and said that Tšepong appeared ready to be fully integrated into the national health system with the staffing structure that OHAfrica had established and recommended to the Lesotho Ministry of Health.  On March 31st, 2010 Tšepong’s clinical and managerial responsibilities were fully transitioned to local public health authorities, at the formal request and direction of the Lesotho Ministry of Health.

“It has been a great privilege to work closely with the Ministry of Health and Social Welfare to design, implement and carry out a sustainable HIV/AIDS treatment program for the people of Lesotho,” said Hilary Short, OHAfrica’s Board Chair. “OHAfrica also acknowledges the talented Canadian health care professionals who shared their skills as well as the international partners and generous donors who have helped contribute to the success of our program.”

OHAfrica’s success was made possible only with the support and involvement of many individuals, including OHAfrica’s partners in Lesotho, our partners and supporters in Canada, and the many Canadians who volunteered their time or took a leave of absence from their professions and families to work at Tšepong Clinic.  Between December 2004 and March 2010, 50 Canadian and international health care professionals worked and volunteered with OHAfrica in Lesotho, providing expertise, enthusiasm and commitment to addressing an urgent health crisis.

OHAfrica HIGHLIGHTS TSEPONG CLINIC

• An average of 300 new HIV positive patients were tested and registered at Tšepong each month between 2004 and 2010.
• An average of 154 new patients were enrolled on life-extending antiretroviral drug treatment each month.
• In March 2010 Tšepong Clinic was one of the largest HIV treatment and referral centres in Lesotho and in southern Africa.
• OHAfrica developed a highly effective model of HIV/AIDS care and treatment that served as a benchmark for other HIV programs in the region.
• OHAfrica supported the development of a comprehensive and effective data management system and continually updated clinical manuals (based on Lesotho’s national guidelines) that were effectively applied by clinic staff and regional health centres.
• In 2007, OHAfrica built an annex building with funding support from UNICEF that currently houses the clinic pharmacy and dispensing unit.
• In 2009, OHAfrica donors supported the building of a much-needed ventilated patient waiting room to accommodate the rapidly expanding patient population and to reduce the risk of infection, primarily from tuberculosis which affects many HIV patients.

• In addition to work at Tšepong Clinic, in 2005 OHAfrica began working closely with community-based primary health care centres throughout the District of Leribe, where Tšepong Clinic is based.
• OHAfrica providing training and mentoring support to community-based nurses and health care providers to help initiate and HIV/AIDS testing, counselling and treatment at the local level, and build HIV-skilled teams throughout the health system.
• Between 2005 and 2010, OHAfrica worked with 22 primary health care centres and filter clinics in Leribe District.
• By 2010, nine centres were providing complete HIV/AIDS treatment and care, including testing, counselling and ARV drug therapy.
• By 2010, all 22 district health centres provided HIV testing and counselling, 12 centres offered pre-ARV care, including CD4 counts, and 9 centres offered ARV treatment.
• By March 2010, an estimated total of 17,200 HIV positive individuals had registered as patients at the community health centres, and an estimated 5,541 patients had been enrolled on ARV drug treatment at the 9 centres offering complete care.

• Between December 2004 and March 2010, OHAfrica supported the placement and service of 54 Canadian and international staff and volunteers at Tšepong Clinic, with postings at Tšepong ranging from 1 month to 29 months in length.  This number includes:
• 29 physicians and HIV specialist physicians
• 13 nurses and nurse practitioners
• 2 pharmacists
• 6 student volunteers
• 3 health care administrative staff
• 1 laboratory manager and mentoring consultant
• In 2005 and 2006, OHAfrica team members took a leading role in developing and conducting national and district training workshops on the World Health Organization’s HIV-specific Integrated Management of Adult and Adolescent Illnesses (IMAAI) certification program. This was done in partnership with the Lesotho Ministry of Health and other international health organizations.
• In addition to ongoing training and mentorship initiatives provided to local health care professionals from 2005 to 2009, OHAfrica funded the salaries and on-the-job training of 29 local staff positions at Tšepong Clinic and at 6 community health centres. From 2004 to 2010, OHAfrica funded the following local staff positions:
• 5 nurses and nurse clinicians
• 2 physicians
• 3 data clerks
• 3 pharmacy technicians
• 10 clinic support workers
• 6 community-based lay counsellors

• In 2005, White Pine Pictures filmed an award-winning documentary called Tšepong: A Clinic Called Hope about OHAfrica’s first months of work at Tšepong.  The film was broadcast on Canadian national television by the Canadian Broadcasting Corporation program, The Nature of Things with David Suzuki.  The film was broadcast several times on CBC and other television networks in 2005 and 2006, and was featured as part of the documentary film festival of the 2006 International AIDS Conference in Toronto in August 2006.
• In November 2004, the Ontario Hospital Association hosted a gala event to launch the OHAfrica project, featuring speeches by special guests, Stephen Lewis, the UN Special Envoy for HIV/AIDS in Africa and the Honourable Dr. Mothoheloa Phooko, Lesotho’s Minister of Health and Social Welfare at the time.
• OHAfrica team members and board members were regularly invited to speak at public events and educational forums from 2005 to 2010, including the OHA’s annual Health Achieve convention in Toronto, Ontario and universities such as the University of Toronto, the University of Guelph, and Queen’s University in Kingston, Ontario.
• At the 2006 IAS International AIDS Conference in Toronto, Canada, The Honourable George Smitherman, the Ontario Minister for Health and Long-Term Care at the time, co-hosted a reception in honour of the OHAfrica program at Queen’s Park, in collaboration with the Ontario Hospital Association.
• OHAfrica presented an abstract at the 2006 AIDS Conference in Toronto addressing preliminary outcomes of antiretroviral therapy to HIV positive children in Lesotho.
• OHAfrica was generously supported and sustained by the commitment and interest of a number of key donors and many individual Canadians. 

THANK YOU TO OHAfrica TEAM MEMBERS, VOLUNTEERS, PARTNERS & SUPPORTERS

The success of OHAfrica was made possible by the participation and expertise of Canadian health care professionals who dedicated their time to the project since it began in December 2004. OHAfrica is grateful to the following individuals for their contributions:

TEAM MEMBERS & VOLUNTEERS IN LESOTHO

• The Basotho personnel, volunteers and community members in Leribe who have contributed to Tšepong Clinic
• The local staff and leadership of Motebang District Hospital
• The Rt. Honourable Pakalitha Mosisili, Prime Minister of Lesotho
• High Commission of the Kingdom of Lesotho, Ottawa
• Minister Counsellor Mr. Moshe Kao, interim Lesotho High Commissioner to Canada
• H.E. M’e Motseoa Senyane, former Lesotho High Commissioner to Canada
• Lesotho Ministry of Health and Social Welfare
• The Honourable Dr. Mphu Ramatlapeng, Lesotho Minister of Health and Social Welfare
• The Honourable Dr. Mothoheloa Phooko, former Lesotho Minister of Health and Social Welfare
• Dr. M. Moteetee, Director General of Health Services, Lesotho Ministry of Health and Social Welfare
• M’e Maud Boikanyo, Director of the STI, HIV/AIDS Directorate, Lesotho Ministry of Health and Social Welfare
• Dr. O. B. Obi, District Medical Officer, Motebang Hospital
• Dr. Limpho Lekena, Tšepong Clinic Consultant-in-Charge, Motebang Hospital
• Baylor International Pediatric AIDS Initiative
• Clinton HIV/AIDS Initiative (CHAI), The Clinton Foundation
• Lesotho Boston Health Alliance
• Phelisanang Bophelong “Live Together in Life” HIV/AIDS Support Group
• Rotary Club of Lesotho, Maloti and Maseru
• UNICEF Lesotho
• Dr. Kathy Ferrer, Baylor-Bristol-Myers Squibb Children’s Clinical Centre of Excellence, Maseru
• Dr. Megan Harkless, Baylor-Bristol-Myers Squibb Children’s Clinical Centre of Excellence, Maseru
• M’e Matoetse Jobo, Training Consultant
• M’e Puleng Lebitsa, President of the Rotary Club of Lesotho, Maloti and Maseru
• Percy Mangoaela, Past President of the Rotary Club of Lesotho, Maloti and Maseru

Direct any inquiries to:

Doug Miller
domiller@oha.com
416 205 1401